Assess infusion site frequently for redness, irritation, or inflammation. If extravasation occurs, infusion must be stopped and restarted elsewhere to avoid damage to subcut tissue. Consider local treatment measures.

If patient has persistent Grade 2 peripheralneuropathy after first dose reduction to 2 mg/m2 : Interrupt vincristine liposome for up to 7 days. If peripheralneuropathy ↑ to Grade 3 or 4, discontinue therapy. If peripheralneuropathy recovers to Grade 1, reduce dose to 1.825 mg/m2 .

If patient has persistent Grade 2 peripheralneuropathy after second dose reduction to 1.825 mg/m2 : Interrupt vincristine liposome for up to 7 days. If peripheralneuropathy ↑ to Grade 3 or 4, discontinue therapy. If peripheralneuropathy recovers to Grade 1, reduce dose to 1.5 mg/m2 .

Intermittent Infusion: Each single dose vial contains 5 mg/31 mL vincristine sulfate. When diluted, final volume is 100 mL. Do not administer solutions that are discolored or contain precipitate. Do not use with in-line filters. Store kit in refrigerator; do not freeze.

Rate: Infuse over 1 hr. Solution must be administered within 12 hr of initiation of preparation.

Y-Site Incompatibility:

Do not mix with other drugs.

Patient/Family Teaching

Instruct patient to read the Patient Information sheet prior to starting vincristine liposome and before each infusion in case of changes.

Instruct patient to notify health care professional immediately if redness, swelling, burning, or pain at injection site occurs.

May cause fatigue and mental impairment. Caution patient to avoid driving and other activities requiring alertness until response to medication is known.

Instruct patient to report symptoms of neurotoxicity (paresthesia, pain, difficulty walking, persistent constipation). Inform patient that increased fluid intake, dietary fiber, and exercise may minimize constipation. Stool softeners or laxatives may be used. Patient should inform health care professional if severe constipation, abdominal pain, bloating, diarrhea, nausea, or vomiting occurs, as this may be a sign of neuropathy.

Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking any new medications, especially St. John's Wort.